Agartala Government Medical College, Tripura, India.
Pan Afr Med J. 2023 Jul 21;45:138. doi: 10.11604/pamj.2023.45.138.37180. eCollection 2023.
the management of an acute spinal cord injury remains controversial. The patient of acute spinal cord injury undergoes several phases of care beginning with the initial trauma management, surgical intervention, and perioperative medical management. The aim of this study was to evaluate the neurological and functional outcome of operative management of traumatic spinal cord injury patients admitted to a tertiary care centre in Northeast India.
thirty patients with spinal cord injury admitted to a tertiary care centre from December 2019 to November 2021, and treated with instrumented stabilisation for spinal cord injury were evaluated until 6 months postoperatively. Patients were evaluated with validated neurological (American Spinal Injury Association scale) and functional outcome measures (Barthel index). Demographic details, mode of injury, morphology, patterns of fractures, neurological level, and management methods in the hospital were recorded and analysed using the Statistical Package for the Social Science (SPSS) version 27.0.
thoracolumbar spinal cord was more commonly injured with 16 (53.3%) patients compared to cervical spinal cord injury patients at 14 (46.7%). Eight patients had complete recovery, 7 patients had incomplete recovery and 15 patients had no recovery. At 6 months post-injury, 18 (60%) patients had favourable functional outcome. American Spinal Injury Association (ASIA) grade at admission was found to be significantly associated with the functional outcome.
after surgery half of the patients had an improvement in their neurology, and functional outcome was favorable which suggests that surgery still holds the key to a better functional and rehabilitation outcome.
急性脊髓损伤的治疗仍存在争议。急性脊髓损伤患者经历几个阶段的治疗,从初始创伤管理、手术干预和围手术期医疗管理开始。本研究的目的是评估在印度东北部一家三级护理中心接受治疗的创伤性脊髓损伤患者手术治疗的神经和功能结果。
2019 年 12 月至 2021 年 11 月,30 例脊髓损伤患者入住一家三级护理中心,接受器械稳定治疗脊髓损伤,并在术后 6 个月进行评估。患者采用经过验证的神经学(美国脊髓损伤协会量表)和功能结果测量(巴氏指数)进行评估。使用社会科学统计软件包(SPSS)版本 27.0 记录和分析人口统计学细节、损伤方式、形态、骨折模式、神经损伤水平以及医院内的治疗方法。
与颈椎脊髓损伤患者 14 例(46.7%)相比,胸腰椎脊髓损伤患者更常见,有 16 例(53.3%)。8 例患者完全恢复,7 例患者不完全恢复,15 例患者无恢复。损伤后 6 个月,18 例(60%)患者功能预后良好。入院时的美国脊髓损伤协会(ASIA)分级与功能预后显著相关。
手术后,一半的患者神经功能有所改善,功能预后良好,这表明手术仍然是获得更好功能和康复结果的关键。